The timing of feeding is important to minimize the risk of your baby spitting up during the procedure.

• Leaving Home: Please do not feed your baby 1 hour before the booked procedure. It is a good idea to feed him just before leaving your home for our clinic.
• Arrival at Clinic: Please do not feed your baby once you have arrived at the office or while you are waiting in the procedure room.
• Keep Baby Dressed: Please keep your baby dressed as normal to ensure they stay warm and comfortable. We will remove their clothing for only the time necessary. Please bring a receiving blanket for your baby.

Upon arriving at the clinic, please follow these steps:

1. Check-In: Go to the front desk on your left and advise the staff you have an appointment for a circumcision.
2. Pharmacy: If you will be using the clinic's on-site pharmacy to obtain your son's prescription and post-circumcision supplies, you will be directed there by our staff. If using an alternate pharmacy, your son's circumcision will require filling of a prescription in advance of the procedure as well as obtaining certain care supplies and bringing them the day of the procedure. Please let us know prior to the day of the procedure if you wish to use an alternate pharmacy and we will send the prescription to your preferred pharmacy. In addition to the prescription, you will need to purchase 3" x 3" gauze and petroleum jelly.
3. Procedure Room: You will eventually be directed to your baby’s private procedure room. Occasionally, there may be a wait due to the volume in the office.

Please have these essential items ready in the room:

• Place 3 diapers and a package of baby wipes on the procedure table.
• Note: Bringing baby wipes and diapers is essential as our physician or nurse will use them to educate you thoroughly on the aftercare dressing changes.
• Please save all your questions for our physician when you meet them in the room.

The circumcision procedure is done in steps.

Local Anesthetic: The initial part of the procedure involves giving your son sucrose (sugar solution) by mouth for pain relief which is followed by an injection of a local anesthetic (freezing) at the base of the penis. This is typically the most uncomfortable part of the entire circumcision.

• Numbing Time: After the injection, you will be left with your son for approximately 5-10 minutes to allow the local anesthetic to take full effect in numbing his penis. Please do not feed your baby during this time.
• Circumcision: The physician will return after 5-10 minutes to complete the circumcision.
• First Comfort/Feeding: Once the procedure is complete, the physician will apply the first dressing, return your baby to you, and leave the room for approximately 10–15 minutes. This is an excellent opportunity to feed and comfort your baby.

• Final Check: After 10–15 minutes have passed, our physician will return to examine your baby’s circumcision and determine suitability for discharge.
• Aftercare Demonstration: During this final examination, our physician or nurse will demonstrate the proper dressing change technique for you.
• Observation: In some cases, additional observation time or intervention for bleeding may be required.

Once your son is discharged:

• Aftercare Package: Please present to our attached pharmacy again. They will have a dressing package prepared for you.
• Dressing package contents:
  • Antibiotic ointment
  • Infant acetaminophen
  • Petroleum jelly
  • Gauze for dressing changes
• Billing Note: The antibiotic ointment and acetaminophen are covered by the Ontario Health Insurance Plan Plus (OHIP+) if your baby is eligible.
• Alternative Pharmacy: If you prefer to have the prescription filled and purchase supplies at another pharmacy then please let us know ahead of time. We will send the prescription to your preferred pharmacy. Petroleum jelly and gauze can be purchased at multiple other pharmacies.